15 Year old Boy Cardiac Arrest

[Keethwan]

My son George collapsed with a cardiac arrest during a 100 meters athletic event at his school. He has not regain consciousness and is in the hospital.  
Basic life support was started only after the ambulance crew arrived and when it was started George was pulse less, cyanosed and had a breathing rate of 2 breadth per minutes. His heart was in a condition called Pulseless Electrical Activity (PEA) and ambulance crew could not shock the heart using the defibrillator.  The duration he was without basic life support (cardio pulmonary resuscitation-CPR- heart massage) after the cardiac arrest is approximately 15 minutes.  Then CPR was done throughout the ambulance journey to hospital and also in the hospital. Doctors after a great effort restarted George’s heart at the hospital after 1 hour and 6 minutes from the time of his collapse. Then was kept in Intensive care for neurological protection at a controlled body temperature of 93 degree Fahrenheit (34 deg centigrade) for 24 hours.  CT scan was done and no brain haemorrhage was found.  However the brain damage was so severe due to blood starvation to the brain. 30 hours later in the hospital doctors confirmed that none of his basic brain function was working to sustain life.
During this time sedative drug s were momentarily stopped and Electro Cardio Grams (EKG)were taken . These EKGs are showing a long Q-T interval. Therefore it is decided that the cause of his cardiac arrest at his school playing field is Long Q-T Syndrome(LQTS). Since then his genes were tested for KCNQ1, KCNH2, KCNE1 andKCNE2 genes. No pathogenic variants were identified. All other immediate family members have been tested and none of them have LQTS.

My main three concerns are
1 As a result of the prolonged cardiac arrest George had, his brain was severely damaged. The next organ most prone to sustain damage due to oxygen starvation is his heart muscle.  In addition his body metabolism subjected to cascade events of instability.  With no active functions in his brain I believe George is not able to restore his fluid balance, electrical activity and normal body metabolism at all.  Were these surrounding circumstances showing a long Q-T interval in his EKG? In other words; was the sequence of events George underwent after his cardiac arrest are responsible for long Q-T interval in his EKG , 30 hours later and now rather than a genetic condition?
2 Ambulance crew could not use the defibrillator.  George’s heart was in a condition called PEA when the ambulance crew arrived. LQTS related arrhythmias can be shocked using defibrillator.  Is this mean that George’s cardiac arrest was not triggered by LQTS?
3 He was tested for legal and illegal drugs and results were negative. There was no brain haemorrhage. Deep vein thrombosis was ruled out as he had a 12 hour long haul flight 2 weeks earlier and was complaining about a pain in right thigh. What other possibilities exist for his cardiac arrest at his school playing field during the athletic event?. What are the main tests that could be done when he is still in hospital ventilator to eliminate all other causes and only to say it is LQTS?

Any medical opinion on this subject is greatly appreciated.

Thank you very much

[Keethwan]

Hello stevie_wonder
Many thanks for your advice.  I will contact www.sads .org to find answers my family needs. Thank you again for your guidance.
Best regards

[Keethwan]

Hello ajrenalli

Thank you for your comments at this very difficult time. I think school did not take it that serious in the beginning. When they realize it was very late.  I really appreciate your time and concern.
Best regards

[stevie_wonder]

I am so terribly sorry that you are going through this. I can understand how you need answers. I have a son who had a cardiac arrest while running and survived. It took almost a year before we found out that it is from LQTS. We have not had genetic results back yet but I do know that the doctors warned us that in 60-70% percent of the families LQTS will not show up in the genetic testing, so that means that 4 out of 10 people with LQTS could possibly not have a known genetic mutation, but it does not mean that the people do not have LQTS. There are several world renowned Long QT specialists in the States. Check out the www.sads.org website to help find a doctor who can help your family. To me, and I am not a doctor, it sounds that your son did have LQTS. The sad thing is that cardiac arrest is often the first and only symptoms some people get. So please find a doctor, an Electrophysiologist, who can help you find these answers.
I hope you find some peace when you find out for sure.

[ajrenalli]

I send my sympathy to you during this difficult time.  I cannot answer your questions as I do not have enough knowledge, but I have one of my own.  Why wasn't CPR started at once?  Surely there must be first aid and someone able to perform CPR at a school function.  I am shocked.